Provider Demographics
NPI:1811737307
Name:TREMBLEY, LUKE (RD, CD, IBCLC)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:TREMBLEY
Suffix:
Gender:M
Credentials:RD, CD, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 FREDRICKSON RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-9308
Mailing Address - Country:US
Mailing Address - Phone:864-323-3085
Mailing Address - Fax:
Practice Address - Street 1:460 FREDRICKSON RD
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-9308
Practice Address - Country:US
Practice Address - Phone:864-323-3085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No174N00000XOther Service ProvidersLactation Consultant, Non-RN